ILYA FATAKHOV
Physician/surgeon


Address: 71-11 Yellowstone Blvd Apt. # 2p, Forest Hills, NY 11375-5202

ILYA FATAKHOV (Credential# 1416813) is licensed (Physician/surgeon) with Connecticut Department of Consumer Protection. The license effective date is May 1, 2020. The license expiration date date is April 30, 2021. The license status is ACTIVE.

Business Overview

ILYA FATAKHOV is licensed with the Department of Consumer Protection of Connecticut. The credential number is #1.056588. The credential type is physician/surgeon. The effective date is May 1, 2020. The expiration date is April 30, 2021. The business address is 71-11 Yellowstone Blvd Apt. # 2p, Forest Hills, NY 11375-5202. The current status is active.

Basic Information

Licensee Name ILYA FATAKHOV
Credential ID 1416813
Credential Number 1.056588
Credential Type Physician/Surgeon
Business Address 71-11 Yellowstone Blvd Apt. # 2p
Forest Hills
NY 11375-5202
Business Type INDIVIDUAL
Status ACTIVE - CURRENT
Active 1
Issue Date 2017-06-23
Effective Date 2020-05-01
Expiration Date 2021-04-30
Refresh Date 2020-04-22

Other licenses

ID Credential Code Credential Type Issue Term Status
1270858 CSP.0059664 CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER 2015-08-26 2019-03-01 - 2021-02-28 ACTIVE
1434099 CSP.0066063 CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER 2017-06-28 2017-06-28 - 2019-02-28 LAPSED

Office Location

Street Address 71-11 Yellowstone blvd Apt. # 2P
City FOREST HILLS
State NY
Zip Code 11375-5202

Licenses in the same zip code

Licensee Name Office Address Credential Effective / Expiration
Berta Shchegol 110-24 67th Drive, Forest Hills, NY 11375 Dentist ~
Lawrence M Rosenbloom 110-11 Queens Blvd., Forest Hills, NY 11375 Architect 2020-08-01 ~ 2021-07-31
Beatrice E Hunt 43 Exeter St, Forest Hills, NY 11375 Professional Engineer 2020-02-01 ~ 2021-01-31
Elena Chachik 108-25 72 Ave 3b, Forest Hills, NY 11375 Dentist 2020-06-10 ~ 2021-03-31
Lina F Spartos 99-15 Ascan Ave., Forest Hills, NY 11375 Registered Nurse 2020-07-01 ~ 2021-06-30
Isabella Mihaelson 100-10 67th Rd #4-g, Forest Hills, NY 11375 Certified General Real Estate Appraiser 2020-05-01 ~ 2021-04-30
Co B Quang 102-30 66th Road #3a, Forest Hills, NY 11375 Casino Class I Employee 2019-12-03 ~ 2020-10-31
Benjamin V Katayev · Vladislav 110-35 67 Drive, Forest Hills, NY 11375 Dentist 2020-06-01 ~ 2021-05-31
Yulian Aminov 112-11 69th Avenue, Forest Hill, NY 11375 Dentist 2020-04-01 ~ 2021-03-31
Laura Marilyn Soriano 7714 113th St, Forest Hills, NY 11375 Professional Counselor 2020-04-01 ~ 2021-03-31
Find all Licenses in zip 11375

Competitor

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City FOREST HILLS
Zip Code 11375
License Type Physician/Surgeon
License Type + County Physician/Surgeon + FOREST HILLS

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Ilya Kholodenko 31 Brook Way, Demarest, NJ 07627 Professional Engineer 2004-05-11 ~ 2005-01-31
Ilya Khaimov 14758 78th Ave, Flushing, NY 11367-3433 Barber 2020-05-01 ~ 2022-04-30
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Dataset Information

Data Provider Connecticut Department of Consumer Protection
Jurisdiction Connecticut
Related Datasets Connecticut Business Registrations, Connecticut Child Care Facilities

This dataset includes 1.41 million licenses issued wtih Connecticut Department of Consumer Protection (TDLR).

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